3.2 The analysis of festival activities in the Shaw’s play: “The paradox of Doctor's Dilemma”

This festival event we held among students of 1 course of specialty "Foreign language: two foreign languages" WKSU name M. Utemissov.

Purpose: to introduce students to the work of Bernard Shaw.

The Shaw Festival produces and presents the work of George Bernard Shaw (1856-1950) and playwrights writing anywhere in the world during, or about, the era of Shaw’s lifetime.

The Shaw Festival chooses works for presentation that are challenging, provocative and intelligent.

• Productions engage audiences with clever, insightful, and delightful portraits of the human condition.

• The works chosen often resonate with the wit, social commentary, and topical relevance for which G.B. Shaw himself was well known.

• The Shaw Festival is dedicated to excellence, consistency, and integrity in all its creative and administrative practices.

• The Shaw Festival operates within a fiscally responsible and accountable framework.

The persons of the play. (The following overviews come from Bernard Shaw’s descriptions)

RedpennyA medical student - assistant to Dr Ridgeon. “...wide-open-eyed, ready, credulous, friendly, hasty youth, with his hair and clothes in reluctant transition from the untidy boy to the tidy doctor” [54].

EmmyAn old serving-woman for Dr Ridgeon. “...an industrious, agreeable, and popular old soul, she is a walking sermon on the vanity of feminine prettiness” [54].

Minnie A hotel maid also married to Louis Dubedat....a pretty, fair-haired woman of about 25.

“Sir Colenso Ridgeon The doctor who is faced with the dilemma. ...a man of fifty who has never shaken off his youth” [54]…. “Even the lines in his face are those of overwork and restless” [54] skepticism, perhaps partly of curiosity and appetite, rather than of age” [54].

Mrs Jennifer Dubedat Dubedat’s lovely wife.... “something of the grace and romance of a wild creature, with a good deal of the elegance and dignity of a fine lady” [54].

Louis Dubedat A young artist dying of tuberculosis ...a slim young man of 23… “although he is all nerves, and very observant and quick of apprehension, he is not in the least shy” [54]... “his artist’s power of appealing to the imagination gains him credit for all sorts of qualities and powers” [54].

Dr Blenkinsop A doctor. ... “clearly not a prosperous man. He is flabby and shabby, cheaply fed and cheaply clothed. He has the lines made by a conscience between his eyes” [54].

Dr Schutz – Macher A schoolmate of Ridgeon A gentleman, well dressed… combination of soft manners and responsive kindliness.

Sir Ralph Bloomfield Bonington A doctor. “ He radiates an enormous self” [54] - satisfaction, “cheering, reassuring, healing by the mere incompatibility of disease or anxiety with his welcome presence” [54].

Sir Patrick Cullen An older doctor. “His name, his plain, downright, sometimes rather arid common sense, his large build” [54]and structure... “are Irish, but he has lived all his life in England” [54].

Cutler Walpole A doctor. ...an energetic, unhesitating man... “his face looks machine-made and beeswaxed; but his scrutinizing, daring eyes give it life and force. He [59] never seems at a loss, never in doubt” [54].

The course of the festival:

Bernard Shaw had a lot to say about doctors, medicine and the medical field in general. He had struggled with health issues his whole life – smallpox, scarlet fever, an infected foot and bouts of migraines and fainting spells to name a few. He wrote a great deal about doctors and had strong views against vivisection and vaccination and questioned the amount of faith we put in doctors, who are themselves only human. In this play, Shaw tests the humanity of a doctor and gives him a moral dilemma. And in that dilemma, familiar questions arise about the ethics of a healthcare system that can only be provided to a few and features a doctor who must decide who deserves treatment. But as Shaw himself said, he is not against doctors: “Please do not class me as one who ‘doesn’t believe in doctors’. One of our most pressing social needs is a national staff of doctors whom we can believe in, and whose prosperity shall depend not on the nation’s sickness but on its health.”

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What is the dilemma? The play opens on the day that Sir Colenso Ridgeon, a prominent re-search doctor, is knighted for discovering a cure for tuberculosis, a serious disease that killed many in the 19th century. His friends gather to congratulate him, including Sir Patrick Cullen, a distinguished old physician; Cutler Walpole, an aggressive surgeon; Sir Ralph Bloomfield Bonington, a charismatic society doctor; and Dr Blenkinsop, a threadbare but honest govern-ment doctor. Each one has his favorite theory of illness and method of cure.[100, p. 21-25].

The play "The Doctors Dilemma" is about Dr. Colenso Ridgeon, who has recently been knightedbecause of a miraculous new treatment he developed for tuberculosis. As his friendsarrive to congratulate him on his success, he is visited by two figures who presenthim with a difficult decision. He has room for one more patient in his clinic; should hegive it to Louis Dubedat, a brilliant but absolutely immoral artist, or Dr. Blenkinsop, apoor and rather ordinary physician who is a truly good person?Dr. Ridgeons dilemma is heightened when he falls in love with Jennifer Dubedat, theartists wife, who is innocent of her husbands profligacy. Ridgeon, with only enoughmedicine to treat one of the two patients, chooses the honorable Blenkinsop overthe rascally Dudebat.In the end Ridgeon justifies his behavior as a plan to let Dubechat die before his wifefind out what an amoral cad he actually was. This, in fact, happens and Dubechatsartistic reputation soars. Dudebat dies, but when Rideon confesses his love toJennifer, he discovers that she has already remarriedCommentary:At one level this comedy--Shaw calls it a "tragedy"--deals with allocation of scarcemedical resources. Which of the two men will Sir Ridgeon save? Blenkinsop is anhonest doctor who works assiduously for the poor. Dubechat is a charmingsociopath, who happens to be an extraordinary artist.The scientist resolves this problem with an interesting moral twist--he reasons thatDubechats death will be a benefit because it will preserve his reputation. It will alsopotentially benefit Ridgeon, who covets Mrs. Dubechat. Various themes swirl aboutwithin this general framework--the value of science, the paternalism of the medicalprofession, and the fact that "everything that goes around, comes around."The play itself is preceded by an 88-page "Preface on Doctors" (1911) in which Shawdeclaims at length about the general inadequacy of medicine in Britain and presentsa proposal for an improved medical care system, including socialized medicine. Alongthe way, he takes off against two of his favorite bugaboos--animal research(vivisection) and vaccination. (Shaw evidently did not believe that vaccination wasefficacious.)

Theatre, London, directed (with Shaw’s help) by Harley Granville Barker, who also played Dubedat. Lillah McCarthy, who had married Barker in April 1906, was Jennifer Dubedat. Barker also directed the first West End production at the

St. James’s Theatre in December 1913, and there have been several major revivals in England since then, including, most recently, an acclaimed Almeida Theatre production in 1998, directed by Michael Grandage. An earlier, 1984, Triumph Productions revival, directed by Peter Coe, starred Colin Firth as Dubedat, but failed to make it to the West End.

Vivien Leigh and Cyril Cusack (succeeded by John Gielgud) played the Dubedats at the Haymarket Theatre in 1942, and at the same theatre in 1963 Anna Massey and Brian Bedford played the roles. Other prominent actors attracted by the play include Joan Plowright, Robin Phillips, and John Neville (Jennifer, Dubedat, and Ridgeon, respectively), at Chichester, 1972, and Lynn Farleigh, Simon Callow, and Nigel Hawthorne (Jennifer, Redpenny, and Walpole, respectively), at the Mermaid Theatre, London, 1975.

The Canadian première was at Toronto’s Princess Theatre on April 2, 1923, in a British touring production by the Cameron Matthews Players. Matthews directed and also played Sir Ralph Bloomfield Bonington.

There have been three previous Shaw Festival productions — in 1969, 1991, and 2000, directed, respectively, by Dillon Evans, Paul Lampert, and Christopher Newton. The dilemma that arises is that the doctor only has enough of his new cure for tuberculosis for one more patient. He inevitably is faced with a difficult moral choice – which patient should receive this final, life-saving treatment? A kindly but poor medical colleague, or an extremely gifted but very unpleasant young artist with a young and vivacious wife with whom the doctor is somewhat in love? His fellow doctors join in the debate:

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Sir Patrick: “Suppose you had this choice put before you: either to go through life and find all the pictures bad but all the men and women good, or to go through life and find all the pictures good and all the men and women rotten. Which would you choose?” [54] ... “To me it’s a plain choice between a man and a lot of pictures.

Ridgeon: “It’s easier to replace a dead man than a good picture” [54].

At one level this comedy (although Shaw calls it a "tragedy") deals with allocation of scarce medical resources; which of the two men will Sir Ridgeon save? Blenkinsop is an honest doc-tor who works assiduously for the poor. Dubedat is a charming sociopath, who happens to be an extraordinary artist. The play also becomes a question not only about the medical establish-ment, but about the place of art in society.

Directed by Morris Panych, with Patrick Galligan as Dr Colenso Ridgeon, Krista Colosimo as Jennifer Dubedat, Michael Ball as Sir Patrick Cullen and Thom Marriott Sir Ralph Bloomfield Bonington, featuring Jonathan Gould as Dubedat, Patrick McManus as Cutler Walpole and Ric Reid as Dr Blenkinsop.

How to recognize a tragic hero

The tragic hero is considered a great person. The hero is a reputable and prosperous individual. Neither a villain nor a model of perfection, but basically good and decent. The tragic hero has a tragic flaw or makes a mistake and a reversal of fortune and as a result things start to unravel for this character–due to some weakness of character, some moral blindness, or error. We should note that traditionally the gods are also in some sense responsible for the hero's fall.

The Doctor’s Dilemma: A tragi – comedy

In a tragic-comedy, wit and humour are used to examine topics that are basically serious. Although Shaw labels his play a ‘tragedy’, it is also very conspicuously and persistently comedic and the elements of tragedy and comedy are intertwined.

Nearly all of Shaw’s plays deal with serious social problems, but the elements of tragedy and comedy play together, making the weighty topics he wrote about easier to digest. He used the stage as a platform for advocating his social and political agenda while entertaining and amusing his audience.

Reality:The inspiration tragic comedy

A provocation

Shaw’s friend, William Archer, challenged Shaw to write a convincing death scene, believing that he was not up to the task. Shaw had never written a death scene before.

A friend

Shaw based his doctor characters and their arguments on real scientists and issues of the day. The model for Dr Ridgeon was Sir Almroth Wright (pictured at left), who invented a very similar treatment for tuberculosis to the one that the fictional Dr Ridgeon did. He also advised Shaw on the scientific elements of the play and became a great friend of Shaw’s, despite their differing views on health and medicine.

A problem

Shaw was present in his friend Sir Almroth Wright’s laboratory when a discussion arose amongst the physicians that were present over admitting an extra tuberculosis patient who had arrived that day for treatment using a new experimental method. Wright’s assistant objected, saying ”we’ve got too many cases “on our hands already.” Shaw then asked: “What would happen if more people applied” [51]to you for help than you could properly look “after?” and Wright” [51]famously “answered: “We should have to consider which life was worth saving” [51].” Shaw laid a finger to his nose and exclaimed: “I smell drama! … I get a whiff of a play.” “Life does not cease to be funny when people die, any more than it” [51].

Discuss

Whose “tragedy” is this?

Sir Colenso Ridgeon’s? The play opens with the news of his knighthood. He has the respect of his peers and a successful career in medicine. By the end, he no longer holds the position of a celebrated healer and believes himself to be a murderer.

Is it Dubedat’s tragedy? He is a brilliant young artist, struck down by disease and denied proper treatment.

Is it Jennifer’s tragedy? She subordinated herself to this egotistical artist and believes (however mistakenly) that when she lost her husband to tuberculosis, she lost a ‘king of men’.

If it weren’t for Ridgeon’s attraction to Jennifer, do you think Ridgeon would have allowed Dubedat to die?

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Did you find humour in the scene where the doctors visit the dying Dubedat?

What do you think of the playwright mixing comedy and tragedy like this?

This scene was controversial in its day for mingling a death with comedy - what we call ‘black comedy’ today. In response to such criticism, Shaw commented (in the play as well as the programme): “Life does not cease to be funny when people die, any more than it ceases to be serious when people laugh” [59]. Do you agree?

Inversion

Shaw delighted in creating topsy-turvy situations, inverting the usual view of things to allow audiences to experience a fresh perspective. In The Doctor’s Dilemma, the usual view of journalism, science and biography is reversed.

Nowhere is there more disagreement and misunderstanding about what the truth is than in those areas where truth is supposedly being empirically verified and reported! The journalist that reports on Dubedat’s death cannot seem to get the facts straight - he can’t even get Dubedat’s name right; the biography Jennifer Dubedat writes about her husband’s life paints a picture that is incomplete - to say the least; and the doctors cannot seem to agree on either the cause or the cure for any disease!

Shaw also reverses the standard view that the appreciation of Art is subjective. Conventional wisdom holds that some will see beauty where others will not. Interestingly, everyone agrees upon the beauty and goodness of Dubedat’s drawings–and that appears to be about the only thing anyone can agree on as a matter of empirical fact. In The Doctor’s Dilemma, beauty is not in the eye of the beholder, but within the work of art.

The scientific view of reality fails to report the truth and the artistic representation of reality triumphs. Opinion turns out to be fact and the ‘facts’ are revealed as opinions.[100, p 30].

The art of medicine

Ridgeon’s ability to save lives gives him a God-like status. What will define him is how he chooses to use this ability. Some artists are also elevated to a God-like status, not because they can affect our mortality, but because they have become immortalized through their work. The artist Gustav Klimt , for example, is in many ways still with us … and where is his doctor?

Art and Medicine have had a long, though not always easy, relationship, representing two sides of a coin.

A few years ago, Harvard Medical School made headlines by hiring two art professors to teach their medical students. In order to make accurate diagnoses, doctors must be able to make accurate observations. A decline in observational skills had been noticed and so the art department was called in to teach medical students the art of observation. Art professors took the medical students to the Boston Museum to look at Jackson Pollack’s abstract #10 (below). Although this painting involves no human anatomy, it demands the ability to recognize patterns and texture–the same two skills that are important in recognizing skin disease! Studying Pollock, Monet,

Gauguin & others increased the students’ abilities to correctly diagnose illness and interpret X-ray by 38%.

Conversely, Leonardo da Vinci - whose paintings The Mona Lisa and The Last Supper are recognized as the most famous paintings in the world - studied in hospitals: dissecting corpses and learning anatomy in order to create drawings of muscles, bones and the heart and vascular system.

It is also worth noting that Shaw generally considered anyone who creates to be an artist, an expanded view of ‘art’ that included new thoughts, theories, and inventions. In this way the classification of ‘artist’ belongs not just to painters and poets but also philosophers, mathematicians, and innovators of all kinds.

Activity

By this way of thinking, the creation of the x-ray, for example, is the work of an art-ist/creator. The first medical x-ray (pictured above) was taken of inventor Wilhelm Rontgen’s wife’s hand.

Continue to investigate the relationship between Art & Medicine. What did you discover? Do you agree that art and medicine are two sides of a coin? Do you agree with Shaw’s definition of ‘Artist’? Write about it.

Socialized medicine

Also called Universal Health Care, it refers to a publicly funded healthcare

system. A hot topic in Shaw’s day, the debate over public vs private health

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care is still being fiercely debated today.

Shaw’s argument for socialized medicine

“It is simply unscientific to allege or believe that doctors do not, under existing circumstances perform unnecessary operations and manufacture and prolong lucrative illnesses” [54], he says. In The Doctor’s Dilemma, we see Cutler Walpole making an excellent living by removing as many ‘nuciform sacs’ as he can. Although Ridgeon tells his colleagues that his patients “might as well get their hair cut for all the difference it makes”[59]. Shaw concludes that this state of things would likely get worse unless the government intervenes to create a public health service in which the doctor is ‘a civil servant with a dignified wage paid out of public funds.’

Shaw believed physicians would have a strong incentive to promote public health while free from worry about their income if their salary were guaran-teed and paid by the government and based on the health of their constituency: a healthy constituency = a healthy salary. This would no doubt provide a physician with the incentive to strive for good public health.

Shaw wrote The Doctor’s Dilemma in 1906 and England’s National Health System (NHS) came into being in 1948 (during Shaw’s lifetime). Shaw welcomed the creation of the NHS but continued to press government to take reform even further, especially advocating lay control (those not actively in-volved in the medical profession) of the General Medical Council, the body responsible for the training and registration (and de-registration) of doctors and surgeons. “At present”, he said “the GMC consists of practicing doctors exactly as if the Prison Commissioners were practicing burglars and murder-ers”. Shaw never got his way on this, but today there is equal lay and medical representation on the governing body of the GMC.

Shaw did not live long enough to see the introduction of a publicly funded health care system in Canada two decades later. And in the United States, the debate continues.

Medical ethics in the Doctor’s Dilemma

Medical ethics involve the study of moral and value judgments as they relate to medicine. The central moral question in The Doctor’s Dilemma is whether Dr Colenso Ridgeon should save Louis Dubedat, a talented, but egotistical artist who ‘borrows’ money with no intention of repayment and deceives his devoted wife Jennifer OR a morally upright, poverty-stricken doctor who treats patients regardless of whether they are able to pay. This central dilemma is further complicated by the fact the Dr. Ridgeon falls in love with Jennifer. The larger question is one of how to decide the value of one life over another and whether the person or body in charge of making such a decision is qualified to do so.

Ridgeon explains his dilemma like this:Imagine … “ten shipwrecked men on a raft - a raft that is barely large enough to save them - that will not support one more. Another head bobs up through the waves at the side. Another man begs to be taken aboard. He implores the captain of the raft to save him. But the captain can only do that by pushing one of his ten off the raft and drowning him to make room for the” [54] newcomer. “That is what you are asking me to do” [54].“

Modern Dilemmas in medical ethics

In the early days of renal dialysis in Canada, when treatments cost $25,000 a year per patient and there were only 2 dialysis machines in the entire country, difficult questions surrounding resource allocation arose: Could society afford this? The scarcity of units in the face of overwhelming need essentially boiled down to the question of who should be saved when not everyone can be saved. The decision to accept some, but not all, for dialysis treatment became one of the major issues that stirred public and professional interest in medical ethics, and opened the medical decision-making process to public scrutiny.

More recently, the H1N1 vaccination raised some important ethical questions, such as: who should be vaccinated first? Should rich countries share their stockpile of medications with less fortunate countries? Who has the authority to make these allocation decisions? Should they have that authority?

Activity

Imagine that you have the power to save lives - but you can only save one life. What kind of criteria would you use to determine who will be saved? Age? Usefulness? Goodness? Beauty? Intelligence? Talent? etc. Why?

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